踝关节镜辅助治疗距骨骨折的临床价值  

Clinical Value of Adjuvant Treatment of Ankle Arthroscopy for Talus Fractures

作　　者：刘永青[1] 李杰峰[2] 林序文[2] 余海滨[1] 苟中坤[2] 何启新[1] 钟文辉[2] 赖西铭[2] 

机构地区：[1]广东省东莞市太平人民医院骨外科,广东东莞523900 [2]广东省东莞市太平人民医院手足外科,广东东莞523900

出　　处：《临床医学工程》2011年第6期840-841,共2页Clinical Medicine & Engineering

基　　金：2009年东莞市科技计划项目(编号:2009105150103)

摘　　要：目的探讨踝关节镜下辅助治疗距骨骨折的优点及体会。方法 2007年4月至2010年12月间,笔者收集了19例距骨骨折病例,按Hawkins分型,其中Ⅰ型骨折4例,Ⅱ型14例,Ⅲ型1例。经关节镜下探查分析:关节软骨损伤15例,韧带损伤8例,合并距骨脱位7例;合并胫(或腓)骨远端骨折11例。分别作镜下关节内清理、关节软骨及韧带修复、骨折内固定等手术治疗,术后指导早期功能锻炼,定期复查X线片。结果术后19例全部随访,时间为6～24个月,平均约13.4个月,其中优12例,良6例,可1例,优良率达94.7%。无一例感染或距骨缺血性坏死等并发症发生。结论踝关节镜下辅助治疗距骨骨折可直视下探查,明确诊断;踝关节镜手术有创伤小、出血少、并发症少等优点,在辅助治疗距骨骨折方面具有较高临床实用价值。Objective To explore the advantages and experience of adjuvant treatment of ankle arthroscopy for talus fractures. Methods From April 2007 to December 2010,the author had collected 19 cases of talar fractures,by Hawkins classification,4 cases were fractures of typeⅠ,11 cases were in type Ⅱ,one case were in type Ⅲ. The arthroscopic probe analysis：15 cases of articular cartilage injury,8 cases of ligament injury,7 cases of combined talar dislocation;11 cases of tibia（or fibula） bone fractures. The surgical treatments of intra-articular endoscopic clearance,articular cartilage and ligament repair,fracture fixation,etc. were implemented,early postoperative functional exercise was guided,X-ray films were reviewed regularly. Results 19 cases were followed up after surgery for 6 ～ 24 months,with an average of 13.4 months,who were excellent in 12 cases,good in 6 cases,fair in one case,the excellent and good rate was 94.7%. No case of infection or complications such as ischemic necrosis of the talus occurred. Conclusion The adjuvant treatment of ankle arthroscopy for talus fractures can be explored under direct vision with definite diagnosis;ankle arthroscopic surgery has the advantages of less trauma,less bleeding,fewer complications,which has higher clinical value in the adjuvant treatment of talus fractures.

关 键 词：踝关节镜 距骨骨折 临床价值 

分 类 号：R683.42[医药卫生—骨科学]